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What is the Value of Testing for Molecular Markers in Advanced NSCLC?

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GRACE Cancer Video Library - Lung

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Memorial Sloan-Kettering Cancer Center medical oncologist Dr. Greg Riely explains how testing for specific mutations in patients with advanced NSCLC can guide prognosis and treatment recommendations.

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When we’re evaluating a patient with lung cancer, the first question we start to ask is, what’s going on with this patient’s cancer? Where is the disease, so has it spread to other sites, and what does it look like under the microscope? So, what’s the tumor histology, is it an adenocarcinoma, squamous cell carcinoma. And then, importantly, molecular testing has become a critical part of our understanding of a patient with lung cancer.

Now, by doing molecular testing, we’re able to better refine the prognostic and predictive value of a variety of drugs and treatments that we have going forward, for designing an overall treatment plan for a patient. Some of the most common testing that should be done are EGFR and ALK — now, these are important because these both have FDA approved drugs that are indicated for abnormalities in EGFR and ALK. If you go beyond those two things, there are actually a long list of drugs that can target individual molecular aberrations and molecular abnormalities, but they’re uncommon, and we don’t have FDA approved drugs for those things, but I think if we go beyond those EGFR and ALK tests, we can learn a lot more and sometimes help patients a great deal.


GRACE Video

Immunotherapy for Lung Cancer: Currently Enrolling Clinical Trials of Combination Therapies

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Immunotherapy Forum Video #25: In Part 2 of 2 videos, Dr. Matthew Hellmann discusses currently enrolling clinical trials for lung cancer patients that study combination therapies (meaning an immunotherapy drug plus another drug is given).


GRACE Video

Targeting the RAF Pathway in Lung Cancer

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Dr. Charles Rudin of Memorial Sloan Kettering talks about RAF and other genetic mutations that play a role in the growth of lung cancer. February 2014.


Squamous Lung Cancer Part 5, Q and A Session by Dr. David Spigel

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Title slide from Squamous Lung Cancer Webinar Q&A SessionDr. David Spigel, Sarah Cannon Cancer Center, answers audience questions about squamous lung cancer.

 

Squamous Lung Cancer Part 5, Q and A Session Audio Podcast


Squamous Lung Cancer, Part 2: Genomic Testing by Dr. David Spigel

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Chart and graph representing genetic mutations across 12 different cancer typesDr. David Spigel, Sarah Cannon Cancer Center, discusses the importance of genomic testing in squamous lung cancer.

 

Squamous Lung Cancer, Part 2: Genomic Testing Audio Podcast

 

What you’ll hear in Part 2:

  • Molecular testing (also called genetic or genomic testing) in squamous lung cancer
  • Newly information about genetic targets for squamous lung cancer

 

Glossary of some terms you’ll hear in Part 2:

Find more cancer definitions at the National Cancer Institute’s Dictionary of Cancer Terms

  • Adenocarcinoma – Cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, or other fluids. Most cancers of the breast, pancreas, lung, prostate, and colon are adenocarcinomas.
  • ALK – A gene that makes a protein called anaplastic lymphoma kinase (ALK), which may be involved in cell growth. Mutated (changed) forms of the ALK gene and protein have been found in non-small cell lung cancer. These changes may increase the growth of cancer cells. Checking for changes in the ALK gene in tumor tissue may help to plan cancer treatment.
  • B-RAF – A gene that makes a protein called B-RAF, which is involved in sending signals in cells and in cell growth. This gene may be mutated (changed) in many types of cancer, which causes a change in the B-RAF protein. This can increase the growth and spread of cancer cells.
  • EGFR – The protein found on the surface of some cells and to which epidermal growth factor binds, causing the cells to divide. It is found at abnormally high levels on the surface of many types of cancer cells, so these cells may divide excessively in the presence of epidermal growth factor. Also called epidermal growth factor receptor, ErbB1, and HER1.
  • Genomics – The study of the complete genetic material, including genes and their functions, of an organism.
  • Oncogenic drivers – That which causes the formation, or supports the progression, of a cancer.
  • Oral therapy – A drug taken by mouth.
  • Personalized medicine – In cancer, personalized medicine uses specific information about a person’s tumor to help diagnose, plan treatment, find out how well treatment is working, or make a prognosis.
  • ROS1 – A receptor tyrosine kinase (RTK) of the insulin receptor family. ROS1 fusions were identified as a potential “driver” mutation in non-small cell lung cancer. (My Cancer Genome)
  • Squamous lung cancer – One of the three sub-types of lung cancer.

 


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